19 Chapter 5 Even though BoNT-A and 2-DL lead to a significant drooling reduction, patients are rarely completely dry after either intervention. We question whether we should be satisfied with the treatment effect when there is no improved quality of life accordingly. The fifth chapter aims to evaluate the impact of drooling on daily life and care, social interaction, and self-esteem after either procedure and 2) compare the relief of the impact of drooling on everyday life and care, social interaction, and self-esteem after BoNT-A compared to 2-DL. Chapter 6 Cost-effectiveness analyses (CEA) are becoming increasingly popular as instruments to facilitate health care decision-making. Though CEAs do not appear to reduce costs, they can aid decision-makers in allocating health care resources more efficiently. BoNT-A is currently the most frequently used intervention to reduce severe drooling. There is, however, limited evidence on the costs and cost-relatedeffectiveness of BoNT-A for the treatment of drooling. 2-DL might rival BoNT-A because of the effect and little related morbidity. The sixth chapter aims to study the costs and cost-related effectiveness of 2-DL compared to BoNT-A after one treatment cycle. Chapter 7 There is little research available that studies the long-term effect of 2-DL. The seventh chapter aims to investigate the subjective 2-DL anterior drooling reduction in the medium to long-term. Chapter 8 There is some degree of recurrence after submandibular duct surgery and in some patients drooling seems refractory to interventions in general. The eighth chapter primarily aims to evaluate the effect of revision surgery for drooling, and secondarily seeks to identify patients characteristics associated with failure of submandibular duct surgery.
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